Table 2 Case 11: Common pediatric cardiac mass characteristics by cardiac magnetic resonance

Benign

 Rhabdomyoma

< 4 years

Intramyocardial or intracavitary; any chamber

Homogeneous on all sequences; no enhancement

Frequent association with tuberous sclerosis

 Fibroma

Majority < 1 year

Ventricular septum or free wall

Peripheral enhancement; signal void due to calcifications

Associated with Gorlin syndrome

 Teratoma

Children

Pericardial; Usually left atrium if intramyocardial (rare)

Multiloculated mixed solid cystic mass

 Hemangioma

Any age

Ventricular septum or right atrium; intramural or endocardial

T2 hyperintense with heterogeneous enhancement; hyperintense on perfusion sequence

Malignant

 Lymphoma

Older children and adolescents

Right atrium and right ventricle more common

Lobulated enhancing mass

Typically non-Hodgkin lymphoma

 Sarcoma

Young children

Right and left atria more common

Infiltrative irregular mass with heterogeneous enhancement; hemorrhagic pericardial effusion may be present

 Metastasis

Any age

Right heart

Variable features depending on primary tumor

Non-neoplastic

 Thrombus

Depends on underlying etiology

Commonly left ventricle; Right atrium in the presence of central venous catheter

Variable signal depending on age of thrombus; no enhancement (surface enhancement may be present in chronic organized thrombus)

Commonly associated with indwelling central venous catheters, congenital heart disease and Kawasaki’s disease